Guidelines for drug monitoring in rheumatic diseases - a german perspective

Because practice variation has been targeted as one major contributor to disproportional increases in healthcare costs, practice guidelines have become more popular in the management of diseases. Practice guidelines that reflect current evidence-based knowledge, including the collective judgment of clinical experts, have been promoted with increasing frequency as a tool to decrease undesirable variation in clinical practice. It is known that clinical guidelines are much more likely to be accepted by practitioners if they have been developed in close collaboration with corresponding professional societies. Consequently, German and American rheumatologists have independently developed practice guidelines for drug monitoring in rheumatic diseases that are endorsed by their national societies of rheumatology. Not surprisingly, both sets of guidelines are very much alike; however, there are distinct differences that mainly represent different healthcare systems in which rheumatology is practiced. Moreover, both guidelines demonstrate differences in the audience addressed, patients covered, and measures of how the guidelines are disseminated. This paper demonstrates the development and implementation process of guidelines for drug monitoring in rheumatic diseases in Germany and the United States. The guidelines are accessible in full length via the Internet.